Offering Patients a Proper Hand

A patient said, "All nurses are different. Some just jab the needle into you, and it hurts."
One of the skills in which I take the most pride as an oncology nurse is my light hand with a needle.

Few things make me feel more successful after I've accessed a port, or given them an injection, than when a patient says, "That was the most painless port access (or injection) I've ever had." I can never promise a patient I won't hurt them, but when I don't, it makes my day.

In art the term "hand" describes the workmanship of an artist. It's also used to describe the talent of hairstylists with scissors, as in "Her haircuts demonstrate good hand." Nurses often tell patients going to surgery "You're in good hands," referring to a surgeon's skill with a scalpel.
But "hand" refers to the way we handle people too, for instance patients.

Whether educating them about chemotherapy and radiation regimens, explaining home medication administration, or simply discussing current events, it's important to remember that even the most optimistic cancer patient is emotionally fragile. The tone of voice used, the abruptness of an encounter, and our choice of words contributes to the "hand" we touch them with emotionally. Too heavy of a conversational hand can pierce or cut a patient's soul as painfully as any needle, shears, or scalpel.

I forgot this on a shift memorable for both the number and acuity of its patients. Everyone had complex questions about their care. I enjoy patient education; however, this shift I was doing so much that I began pulling information from my knowledge base as if it were files from a computer. By this, I mean remotely. I wasn't paying attention to hand, my personal touch.

During the course of her assessment, the patient revealed she'd taken herself off of a prescribed home medication because of its side effects. Then this patient reported a clinical symptom, which I recognized was caused by the discontinuation of the home medication, she'd just mentioned, and I just sort of blurted out my observation. Immediately, I regretted my heavy-handedness as I saw this otherwise optimistic patient crumble almost to the point of tears. I had carelessly broken a tender reed.

Needing to make amends, I sat on the rolly stool, and I apologized to her. I complimented not only her involvement in her care, but her ability to sense the changes in her body as well. I also apologized for abruptly responding to the discontinuation of her medication, and the side effect. I regained my usual touch, she forgave me, and we came up with a plan for her.

I hope I made up for my carelessness of hand. I had hurt her, as if I'd just jabbed her with a needle.

What tips can you offer busy nurses for developing a gentle "hand" with patients, either physically or metaphorically?

Itís Just a Little ExposureJulianna Paradisi, RN, OCN, 6/23/2015 15 Staring meditatively at a painting I'm working on, I notice my fingerprints in oil paint on my coffee mug. Glancing around, I see I've left a small trail of blue, red, and brilliant ...